PDF(Pubmed)
Abstract：
Serum prostate-specific antigen (PSA) needs to be monitored with ultrasensitive PSA assays (uPSAs) for oncologists to be able to start salvage radiotherapy (SRT) while PSA is <0.5 µg/L for patients with prostate cancer (PCa) relapsing after a radical prostatectomy (RP). Our systematic review (SR) aimed to summarize uPSAs for patients with localized PCa. The SR was registered as InPLASY2023110084. We searched for studies on Google Scholar, PUBMED and reference lists of reviews and studies. We only included studies on uPSAs published in English and excluded studies of women, animals, sarcoidosis and reviews. Of the 115 included studies, 39 reported PSA assay methods and 76 reported clinical findings. Of 67,479 patients, 14,965 developed PSA recurrence (PSAR) and 2663 died. Extremely low PSA nadir and early developments of PSA separated PSAR-prone from non-PSAR-prone patients (cumulative p value 3.7 × 1012). RP patients with the lowest post-surgery PSA nadir and patients who had the lowest PSA at SRT had the fewest deaths. In conclusion, PSA for patients with localized PCa in the pre-PSAR phase of PCa is strongly associated with later PSAR and survival. A rising but still exceedingly low PSA at SRT predicts a good 5-year overall survival.
摘要：
需要使用超灵敏的PSA测定法（uPSA）监测血清前列腺特异性抗原（PSA），以便肿瘤学家能够开始抢救放疗（SRT），而对于前列腺癌（PCa）复发的患者，PSA<0.5µg/L根治性前列腺切除术（RP）。我们的系统评价（SR）旨在总结局限性PCa患者的uPSA。SR注册为InPLASY2023110084。我们搜索了谷歌学者的研究，发表评论和研究的参考清单。我们只纳入了以英语发表的关于uPSA的研究，而排除了对女性的研究，动物,结节病和评论。在纳入的115项研究中，39例报告了PSA测定方法，76例报告了临床发现。在67,479名患者中，14,965例发生PSA复发（PSAR），2663例死亡。极低的PSA最低点和PSA的早期发展将PSAR易感患者与非PSAR易感患者分开（累积p值3.7×1012）。术后PSA最低点最低的RP患者和SRT时PSA最低的患者死亡最少。总之,在PSAR前期有局限性PCa的患者的PSA与后期PSAR和生存率密切相关。SRT时PSA上升但仍极低，预测5年总生存率良好。
